Association between musculoskeletal pain in Japanese construction workers and job, age, alcohol consumption, and smoking

Prevalence, pattern and risk factors for work-related musculoskeletal disorders among Nigerian plumbers

Plumbing work is more manually driven in low-and-middle income countries (LMICs), and the prevalence of work-related musculoskeletal disorders (WMSDs) among workers who engage in plumbing in LMICs may be worse than earlier reports from developed countries. This study aimed to assess the prevalence, pattern and risk factors for work-related musculoskeletal disorders (WMSDs) among Nigerian plumbers. A total of 130 consenting plumber participated in this cross-sectional study. The Nordic Musculoskeletal questionnaire and the Job Factor Questionnaire were used to assess information on prevalence and pattern of WMSDs; and perceptions regarding work-related risks factors for WMSDs. Descriptive (mean, frequency, range, percentage and standard deviation) and inferential (Chi-square) statistics were used to analyze data. Alpha level was set at p<0.05. The mean age of the respondents is 36.56 ± 10.418 years. The mean years of experience and working hours per day are 14.15 ± 9.161 years and 8.28 ± 2.512 hours. Job characteristics were mostly installation of pipes and fixtures (99.2%), equipment and fixtures prior to installation (96.9%), and testing of plumbing system for leaks (88.5%). 12-month and 7-day prevalence of WMSDS were 84.6% and 50.8%. Low-back (63.8%), neck (55.4%) and knee (50%) were the most affected body sites. Having WMSDs limits normal activities involving the low-back (32.3%), knee (25.4%) and neck (23.8%). There was significant association between 12-month prevalence of WMSDs and use of saws and pipe cutters (χ² = 4.483; p = 0.034), while sites of affectation had significant association with 12-month and 7-day prevalence of WMSDs (p<0.05) respectively. Nigerian plumbers have a high prevalence of WMSDs affecting most commonly the low back, neck and knee. Plumbing job factors pose mild to moderate risk to developing WMSDs, and use of saws and pipe cutters significantly influence WMSDs.

Work-related musculoskeletal disorders among Pakistani construction workers: Prevalence, characteristics, and associated risk factors

BACKGROUND: Worldwide, approximately 350 million people are currently employed in the construction industry. OBJECTIVE: To determine the prevalence, pain characteristics, and associated risk factors for musculoskeletal disorders (MSDs) among construction workers in Pakistan. METHODS: This study was a cross-sectional survey conducted from February to August 2019 among 666 construction workers. The data were collected using a questionnaire consisting of 4 sections: demographic information, a numerical pain intensity rating scale, a Nordic questionnaire to report prevalence, and pain characteristics. SPSS was used for data entry and analysis. RESULTS: The mean age of the construction workers was 34.49 years. Participants who reported pain were 397 out of 666 and 269 were those who reported no pain. The 12-month prevalence of pain among construction workers in more than one body area was 89% (n = 591) and the 7-day prevalence was 52% (n = 343); lower back pain was the most common type of pain with a 12-month prevalence of 27% (n = 180) and a 7-day prevalence of 17% (n = 112). Regarding the characteristics of the pain, 26% (173) of the workers suffered pain occasionally, 27% (180) participants had pain for≤2 hours per day, and 32.9% (219) had dull pain. Moreover, a significant relationship was found (p < 0.05) between MSDs and age, lifestyle, work experience, smoking habits, and absence from work. CONCLUSION: Musculoskeletal pain is highly prevalent, with lower back pain being the most commonly reported type. Absence from work and disability in performing normal daily activities have been reported as consequences of musculoskeletal pain. Moreover, this study underscores the importance of targeted preventive healthcare measures for construction workers.

Shoulder pain prevalence by age and within occupational groups: a systematic review

Background

Shoulder pain was previously shown to diminish in older populations and it was suggested that this could be explained by reduced usage with age. Our objectives were to investigate if estimates of shoulder pain continue to increase after the age of 50 in working populations and to compare these estimates in physically demanding occupations with sedentary occupations.

Methods

A systematic review of retrospective, cross-sectional, prospective, or longitudinal.

studies reporting prevalence or incidence of non-specific shoulder pain in occupational groups stratified by age. Searches were conducted in PubMed, Scopus, and CINAHL from inception until January 2020. Study characteristics and prevalence estimates stratified by age were extracted. Two reviewers independently performed a critical analysis of the included studies to determine their validity and risk of bias.

Results

Twenty studies with a total of 40,487 participants and one study of a clinical data base were included and assigned a direction of the estimates for shoulder pain as either ‘increasing’, ‘remaining stable’ or ‘decreasing’ past the age of 50. Shoulder pain generally increased past 50, with 16 of the 21 included studies reporting higher estimates/odds ratios in older participants. In the more physically active occupations over 50, the estimates increased in 14 of the 18 samples compared to only two of the four involving sedentary occupations.

Conclusions

Shoulder pain prevalence remains common in workers beyond the age of 50. Prevalence continues to increase in physically demanding occupations. Clinicians should consider factors of occupation when managing shoulder pain.

Trial registration

PROSPERO (CRD42019137831).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40945-021-00119-w.

Factors associated with low back pain among construction workers in Nepal: A cross-sectional study

BACKGROUND

Low back pain (LBP) is the commonest cause of disability throughout the world. This study aimed to determine the prevalence and factors associated with LBP among the construction workers in Nepal.

METHODS

A community-based cross-sectional study was conducted among the construction workers working in Banepa and Panauti municipalities of Kavre district, from September 2019 to February 2020. Data was collected purposively by face-to-face interview from 402 eligible participants from the both municipalities using semi-structured questionnaire. Mobile-based data collection was done using KoboCollect. Data were exported to and analysed using R-programming software (R-3.6.2). Univariate and multivariate logistic regressions were performed. All tests were two tailed and performed at 95% confidence interval (CI).

RESULT

One-year prevalence of LBP among construction workers were 52.0% (95%CI: 47.0-57.0). The higher odds of LBP was reported among females [adjusted odds ratio (aOR) = 2.42; 95%CI: 1.12-5.23], those living below poverty-line (aOR = 2.35; 95%CI: 1.32-4.19), participants with more than five years of work experience (aOR = 1.66; 95%CI: 1.01-2.73) and those with intermediate sleep quality (aOR = 2.06; CI: 1.03-4.11). About 80.0% of construction workers with LBP never seek healthcare services due to: a) time constraints (90.9%), b) financial constraints (18.1%) and c) fear of losing wages on seeking healthcare services (40.9%). The majority of the participants (94.8% among those without LBP and 72.3% among those with LBP) did nothing to prevent or manage LBP.

CONCLUSION

The prevalence of LBP in the past one year was high among construction workers where majority of workers never did anything to prevent or manage LBP. Therefore, the public health professionals should set up the health promotion, education, and interventions aimed at increasing awareness on preventive techniques and predisposing factors of LBP.

Incidence and risk factors for poor ankle functional recovery, and the development and progression of posttraumatic ankle osteoarthritis after significant ankle ligament injury (SALI): the SALI cohort study protocol

Background

Ankle sprains are one of the most common musculoskeletal injuries, accounting for up to 5% of all Emergency Department visits in the United Kingdom. Ankle injury may be associated with future ankle osteoarthritis. Up to 70% of ankle osteoarthritis cases may be associated with previous ankle injury. There is limited research regarding the association between ankle sprain and ankle osteoarthritis development. The current study aims to phenotype those who suffer significant ankle ligament injuries, identify potential risk factors for ankle injuries and subsequent poor recovery, examine why individuals may develop osteoarthritis, and what factors influence this chance.

Methods

In this multicentre cohort study participants were recruited from nine Emergency Departments and two Urgent Care Centres in the United Kingdom. Participants (aged 18–70 years old) were defined as those who had suffered an isolated acute ankle sprain, which was Ottawa Ankle Rules positive, but negative for a significant ankle fracture on x-ray. Age and sex matched controls were also recruited. The controls were individuals who had not suffered a significant ankle injury, including ankle pain, function affected for more than 7 days, or the ankle caused them to report to an Emergency Department. Data is collected through a series of seven questionnaires (at baseline, 3 months, 1 year, 3 years, 5 years, 10 years, and 15 years later). The questionnaires include four sections (demographic questions; index injury, and injury history questions; functional assessment questions; and quality of life questions) and are designed to collect detailed information about the individual, their injury, potential risk factors for ankle sprains and ankle osteoarthritis, plus their medical history and any medication consumed.

Discussion

The Significant Ankle Ligament Injury (SALI) study aims to add to the limited knowledge regarding which factors can predict ankle sprains, complaints, and osteoarthritis. This is important because despite ankle sprains being regarded as a benign injury that resolves quickly, residual symptoms are not uncommon months and years after the injury.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04230-8.

The Influence of Tobacco Use, Alcohol Consumption, and Weight Gain on Development of Secondary Musculoskeletal Injury After Lower Limb Amputation

OBJECTIVES

To evaluate whether tobacco use, alcohol consumption, and weight gain are associated with the diagnosis of overuse musculoskeletal injuries within the first 12 months after lower limb amputation.

DESIGN

Retrospective cohort study.

SETTING

Military treatment facilities.

PARTICIPANTS

Service members (N=681) with a deployment-related lower limb amputation.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Clinical diagnosis codes associated with musculoskeletal overuse injuries of the lower limb, upper limb, and low back regions.

RESULTS

In the first three months after amputation, tobacco use and alcohol consumption were reported in 55.7% and 72.0%, respectively, of the retrospective sample. The overall mean weight change was 22.9±23.6 pounds. The prevalence of reporting at least 1 overuse injury within 4 to 12 months after amputation was 57.0% in the sample, with prevalence rates of lower limb, upper limb and low back pain diagnoses at 28.3%, 21.7%, and 21.1%, respectively. Service members reporting tobacco use in the first 3 months after amputation were nearly twice as likely to be diagnosed with a lower limb musculoskeletal injury 4 to 12 months after amputation. Similarly, service members reporting alcohol consumption within the first 3 months after amputation were more than twice as likely to be diagnosed with at least 1 overuse musculoskeletal injury 4 to 12 months after amputation. However, weight change or maximum weight after amputation were not associated with the diagnosis of an overuse musculoskeletal injury.

CONCLUSIONS

Development of secondary overuse musculoskeletal injury appears to be related to tobacco use and alcohol consumption, but not to weight gain. These findings warrant focused research efforts toward developing preventive interventions.

A Survey of Work-Related Pain Prevalence Among Construction Workers in Hong Kong: A Case-Control Study

Construction workers undertake demanding physical work and face high risk of injuries in poor working environments. This case-control study investigated the extent of their musculoskeletal pain incidence at work. A total of 2021 construction workers in different trades were interviewed on-site in a survey from December 2017 to December 2018. The survey results revealed that the pain prevalence of the subjects in the last 24 h was 10.6 %. The worst and top most common pain spots caused by work were central lower back, left/right shoulders, and knees. Regarding pain management, their most common method was to ignore the pain (21.4%). The average percentage of pain relief after receiving treatment in the 24 h was 37.12%. Besides, significant differences were found between the pain and non-pain groups regarding their employment duration in current job or their average sleep duration in the 24 h. The study showed that those with multiple and bilateral pain sites had pain interference on their living activities.

The prevalence of musculoskeletal symptoms in the construction industry: a systematic review and meta-analysis

PURPOSE

Although individual studies have reported high prevalence of musculoskeletal symptoms (MSS) among construction workers, no systematic review has summarized their prevalence rates. Accordingly, this systematic review/meta-analysis aimed to synthesize MSS prevalence in different construction trades, gender and age groups, which may help develop specific ergonomic interventions.

METHODS

Nine databases were searched for articles related to the research objective. Two reviewers independently screened citations, extracted information and conducted quality assessment of the included studies. Meta-analyses were conducted on clinical and statistical homogenous data.

RESULTS

Thirty-five out of 1130 potential citations were included reporting diverse types of period prevalence and case definitions. Only the 1-year prevalence rates of MSS (defined as at least one episode of pain/MSS in the last year) at nine anatomical regions had sufficient homogeneous data for meta-analysis. Specifically, the 1-year prevalence of MSS was 51.1% for lower back, 37.2% for knee, 32.4% for shoulder, 30.4% for wrist, 24.4% for neck, 24.0% for ankle/foot, 20.3% for elbow, 19.8% for upper back, and 15.1% for hip/thigh. Female workers demonstrated a higher prevalence of MSS while there was insufficient information on the prevalence of trade-specific or age-related MSS. The quality assessments revealed that many included studies estimated prevalence solely based on self-reported data, and did not report non-respondents' characteristics.

CONCLUSIONS

Lumbar, knee, shoulder, and wrist MSS are the most common symptoms among construction workers. Future studies should standardize the reporting of period prevalence of MSS in different construction trades to allow meta-analyses and to develop relevant MSS prevention program.

Structural equation modelling of lower back pain due to whole-body vibration exposure in the construction industry

Whole-body vibration (WBV) exposure is a health hazard among workers, causing lower back pain (LBP) in the construction industry. This study examines key factors affecting LBP due to WBV exposure using exploratory factor analysis and structural equation modelling. The results confirm five key factors (equipment, job related, organizational, personal, social context) with their 17 associated items. The organizational factor is found the most important, as it influences the other four factors. The results also show that appropriate seat type, specific training programme, job rotation, workers' satisfaction and workers' physical condition are crucial in reducing LBP due to WBV exposure. Moreover, provision of new machines without proper training and good working condition might not help reduce LBP due to WBV exposure. The results help the construction companies to better understand key factors affecting LBP due to WBV exposure, and to plan for a better health improvement programme.

Work-related musculoskeletal disorders among construction workers in the United States from 1992 to 2014

OBJECTIVES

Examine trends and patterns of work-related musculoskeletal disorders (WMSDs) among construction workers in the USA, with an emphasis on older workers.

METHODS

WMSDs were identified from the 1992-2014 Survey of Occupational Injuries and Illnesses (SOII), and employment was estimated from the Current Population Survey (CPS). Risk of WMSDs was measured by number of WMSDs per 10 000 full-time equivalent workers and stratified by major demographic and employment subgroups. Time series analysis was performed to examine the trend of WMSDs in construction.

RESULTS

The number of WMSDs significantly dropped in the US construction industry, following the overall injury trends. However, the rate of WMSDs in construction remained higher than in all industries combined; the median days away from work increased from 8 days in 1992 to 13 days in 2014, and the proportion of WMSDs for construction workers aged 55 to 64 years almost doubled. By occupation, construction labourers had the largest number of WMSD cases, while helpers, heating and air-conditioning mechanics, cement masons and sheet metal workers had the highest rates of WMSDs. The major cause of WMSDs in construction was overexertion, and back injuries accounted for more than 40% of WMSDs among construction workers. The estimated wage loss for private wage-and-salary construction workers was $46 million in 2014.

CONCLUSIONS

Construction workers continue to face a higher risk of WMSDs. Ergonomic solutions that reduce overexertion-the primary exposure for WMSDs-should be adopted extensively at construction sites, particularly for workers with a higher risk of WMSDs.

Assessing the exposure of street sweeping and potential risk factors for developing musculoskeletal disorders and related disabilities: a cross-sectional study

OBJECTIVE

This study aims to assess the exposure of those involved in street sweeping to the development of musculoskeletal disorders (MSDs) and related disabilities and tries to identify the individual risk factors thereof.

DESIGN

A cross-sectional survey was conducted among street sweepers together with a comparison group. A modified Standardized Nordic Questionnaire was adopted to measure the prevalence of MSDs and related disabilities. The impact of the occupation of sweeping on the development of MSDs and related disabilities was assessed using the propensity score matching (PSM) method. A multivariate logistic regression model was employed to identify the individual risk factors.

PARTICIPANTS

Street sweepers (n=180) and a comparison group (n=180), working for at least a year as formal employees of the Municipal Corporation of Greater Mumbai (MCGM), were randomly selected from 6 municipal wards.

RESULTS

The prevalence of the MSDs was significantly higher among the sweepers for shoulders (32%), wrists/hands (29%), elbows (27%) and neck (17%) compared with the comparison group, in which the prevalence was 11%, 19%, 9% and 11%, respectively. The disabilities too were significantly higher among the street sweepers for the lower back (27%), upper back (27%), wrists/hands (26%), shoulders (24%) and elbows (23%) compared with the comparison group, for which the figures were 18%, 19%, 13%, 9% and 6% respectively. The PSM method highlighted that the occupation of sweeping raised the risk of developing MSDs and disabilities particularly for the shoulders (17-16%), wrists/hands (14% each), elbows (13% each) and the upper back (12-13%). After adjusting the age, body mass index and the caste of the street sweepers, the number of years of engagement in street sweeping and the location of work emerged as potential risk factors in the development of MSDs and, thereby, related disabilities.

CONCLUSIONS

The study concluded that the occupation of street sweeping raises the risk of MSDs and related disabilities. This study recommends preventive and curative measures to deal with MSDs among street sweepers.

Impact of the number of painful stimuli on life satisfaction among Korean industrial accident workers completing convalescence: dual mediating effects of self-esteem and sleeping time

This study examined the impact of the number of painful stimuli on life satisfaction among workers who experienced an industrial accident and investigated how self-esteem and sleeping time affected life satisfaction. The Korea Workers' Compensation & Welfare Service conducted the first nationwide panel survey on occupational health and safety insurance in 2013-2014 through a stratified systematic sampling on 2,000 industrial accident workers who completed convalescence. Based on the dataset, our study analyzed 1,832 workers experiencing an industrial accident after excluding 168 disease patients. For the research model analysis, a four-stage hierarchical regression analysis technique was applied using the SPSS regression analysis Macro program of PROCESS Procedure. To test mediated indirect effects of the self-esteem and sleeping time, the bootstrapping technique was applied. Life satisfaction, self-esteem and sleeping time decreased as the number of painful stimuli increased. Life satisfaction decreased as self-esteem and sleeping time decreased. On balance, the partial mediation model confirmed that self-esteem and sleeping time both mediate the impact of the number of painful stimuli on life satisfaction.

Significant Efficacy of Tramadol/Acetaminophen in Elderly Patients with Chronic Low Back Pain Uncontrolled by NSAIDs: An Observational Study

Chronic low back pain (LBP) is a common condition and is generally treated using non-steroidal anti-inflammatory drug (NSAID); however, chronic NSAID use can decrease renal function. Tramadol, a weak opioid agonist, may improve chronic LBP and disability, while avoiding adverse effects such as gastrointestinal and renal toxicity. However, few studies have evaluated the short-term efficacy of opioids in Asian patients with chronic LBP. In this study, 24 patients with chronic LBP unresponsive to NSAIDs (10 men, 14 women; mean age, 65.1 ± 12.1 years) were prescribed tramadol/acetaminophen (37.5 mg/325 mg; four tablets daily) for 1 month. Then, the following parameters were assessed at baseline and after 1 week and 1 month of treatment: leg pain and LBP (Visual Analog Score [VAS]); activity of daily life (Roland-Morris Disability Questionnaire [RDQ]); and disability (Oswestry Disability Index [ODI]). Leg pain resolved within 1 week (p = 0.00093); however, LBP was relieved only at 1 month (p = 0.00034). The mean RDQ (p = 0.015) and ODI (p = 0.0032) scores were improved at 1 month. A total 41.6% of patients reported nausea and floating sensation beginning tramadol/acetaminophen treatment, and 12.5% (four patients) discontinued treatment as a result. LBP did not improve in 25% of patients administered tramadol/acetaminophen. Because this was an observational study, rather than a comparative study, further investigation is needed to evaluate the long-term efficacy of tramadol/acetaminophen in elderly patients with chronic LBP unresponsive to NSAIDs.

Prevalence of musculoskeletal pain in construction workers in Saudi Arabia

The objective of this study was to find out the prevalence, characteristics, and distribution of musculoskeletal pain among construction workers in Saudi Arabia. A questionnaire about musculoskeletal pain in different parts of the body was completed by 165 construction workers from the construction industries in Dammam and Riyadh cities. The descriptive data were analyzed using chi-square test. The level of statistical significance was set at P < 0.05. Eighty (48.5%) of the responding workers had pain in neck, shoulders, lower back, hand, knee, or ankle. The majority of respondents had low back pain (50%) followed by knee pain (20%). The average intensity of pain at all sites during activity and rest was 6.65 and 3.59, respectively. Thirty-four (42.5%) respondents had dull aching pain and 24 (30%) had cramping pain. There was an association between years of experience, duration of break during work, and use of protective equipment with the prevalence of musculoskeletal pain in construction workers (P < 0.05). Most of the workers complaining of pain got medical treatment (62.5%) and only 25% received physical therapy. It can be concluded from this study that the prevalence of musculoskeletal pain among construction workers in Saudi Arabia is high.

Is alcohol intake associated with low back pain? A systematic review of observational studies

BACKGROUND

Alcohol intake has been widely reported as a risk factor for low back pain (LBP), however, the literature is inconclusive about this association.

OBJECTIVES

To determine, in a systematic review, the relationship between alcohol intake and LBP.

METHODS

A search was conducted in CINAHL, LILACS, Medline, National Research Register and Web of Science to identify studies that investigated the association between alcohol intake and LBP. Quantitative results and its estimators were extracted. When possible, meta-analyses were performed using a random effects model.

RESULTS

Twenty-six studies were included in this review. Twenty-three studies were retrospective cohorts, two were case-controls, and one employed a longitudinal design. Pooled results from nine studies (two case-controls and seven retrospective cohorts) showed that alcohol consumption is slightly associated with LBP (OR: 1.3; 95% CI: 1.1-1.5). This association appears to be present in studies investigating alcohol as an abuse dependence substance in chronic LBP. Remaining individual studies tended to report no statistical significant association. No dose-response relationship was identified. Only one longitudinal study was identified and even though alcohol consumption was found to be negatively associated with a future episode of LBP (OR: 0.7; 95% CI: 0.5-0.9) this association lost significance for future incidence of LBP in people with no LBP at baseline.

CONCLUSIONS

Alcohol consumption appears to be associated with complex and chronic LBP only and in people with alcohol consumption dependence. Clinicians in the musculoskeletal field could use this information to design educational strategies for this population.

Prevalence and correlates of regional pain and associated disability in Japanese workers

OBJECTIVES

To assess the prevalence and correlates of regional pain and associated disability in four groups of Japanese workers.

METHODS

As part of a large international survey of musculoskeletal symptoms (the CUPID study), nurses, office workers, sales/marketing personnel and transportation operatives in Japan completed a self-administered questionnaire (response rate 83%) covering experience of pain in six anatomical regions, associated disability and sickness absence, and various possible occupational and psychosocial risk factors for these outcomes. Associations with risk factors were assessed by logistic regression.

RESULTS

Analysis was based on 2290 subjects. Rates of regional pain were generally less than in the UK, with a particularly low prevalence of wrist/hand pain among office workers (6% in past month). The strongest and most consistent risk factor for regional pain in the past month was tendency to somatise (ORs (95% CIs) for report of ≥ 2 versus 0 distressing somatic symptoms 3.1 (2.4 to 4.0) for low back pain, 2.8 (2.1 to 3.8) for shoulder pain, and 2.5 (1.6 to 4.1) for wrist/hand pain). Sickness absence for regional pain complaints in the past year was reported by 5% of participants, the major risk factor for this outcome being absence during the same period for other medical reasons (OR 3.7, 95% CI 2.4 to 5.8).

CONCLUSIONS

Japanese office workers have markedly lower rates of wrist/hand pain than their UK counterparts. In Japan, as in Western Europe, somatising tendency is a major risk factor for regional pain. Sickness absence attributed to regional pain complaints appears to be much less common in Japan than in the UK, and to be driven principally by a general propensity to take sickness absence.

The association between smoking and low back pain: a meta-analysis

OBJECTIVE

To assess the association between smoking and low back pain with meta-analysis.

METHODS

We conducted a systematic search of the MEDLINE and EMBASE databases until February 2009. Eighty-one studies were reviewed and 40 (27 cross-sectional and 13 cohort) studies were included in the meta-analyses.

RESULTS

In cross-sectional studies, current smoking was associated with increased prevalence of low back pain in the past month (pooled odds ratio [OR] 1.30, 95% confidence interval [CI], 1.16-1.45), low back pain in the past 12 months (OR 1.33, 95% CI, 1.26-1.41), seeking care for low back pain (OR 1.49, 95% CI, 1.38-1.60), chronic low back pain (OR 1.79, 95% CI, 1.27-2.50) and disabling low back pain (OR 2.14, 95% CI, 1.11-4.13). Former smokers had a higher prevalence of low back pain compared with never smokers, but a lower prevalence of low back pain than current smokers. In cohort studies, both former (OR 1.32, 95% CI, 0.99-1.77) and current (OR 1.31, 95% CI, 1.11-1.55) smokers had an increased incidence of low back pain compared with never smokers. The association between current smoking and the incidence of low back pain was stronger in adolescents (OR 1.82, 95% CI, 1.42-2.33) than in adults (OR 1.16, 95% CI, 1.02-1.32).

CONCLUSIONS

Our findings indicate that both current and former smokers have a higher prevalence and incidence of low back pain than never smokers, but the association is fairly modest. The association between current smoking and the incidence of low back pain is stronger in adolescents than in adults.

Subjective musculoskeletal symptoms in winter and summer among indoor working construction electricians

To evaluate the effects of cold exposure on the musculoskeletal system, two surveys on the subjective musculoskeletal symptoms among male electricians working in the buildings under construction were performed in winter (N=74) and summer seasons (N=83). A self-administered questionnaire was used to collect information on age, occupational career, working habit, present illness, and subjective musculoskeletal symptoms. Mean age, occupational career and daily smoking of the supervisors were significantly higher than those of the other subjects. In general, prevalence rates of stiffness, numbness, pain and Raynaud's phenomenon in the fingers, finger cold sensation, dull movement of the fingers, pain in the wrist, knee joint pain, pain and numbness in the foot and foot cold sensation in winter were significantly higher than those in summer. These results were marked especially in the workers except supervisors. In winter, there were no significant differences in the prevalence rates of subjective musculoskeletal complaints between the supervisors and the other workers. On the other hand, in summer, prevalence of stiffness and pain in the shoulder, stiffness and pain in the neck, dullness and pain in the arm, finger cold sensation, low back dullness and low back pain in the supervisors were significantly higher than those in the other workers. These results suggest that effects of cold on the musculoskeletal symptoms markedly appeared in the workers except supervisors.

Menstrual disorders and their influence on low back pain among Japanese nurses

An increasing body of evidence now suggests that menstrual disorders may influence the development of Low Back Pain (LBP) among women of reproductive age. To investigate this issue in Japan, we conducted a large cross-sectional survey of female nurses from a university teaching hospital during 2008. Nurses reported a wide range of symptoms both prior to and during menstruation, including breast tenderness, stomach pain, light headedness and fatigue. Around three-quarters had experienced at least one episode of LBP in the previous 12-months, with most symptoms lasting one week or less. Increasing body weight was correlated with an increased risk of LBP affecting their daily activities (OR: 12.94, 95%CI: 1.54-116.56). Having three or more children was correlated with a reduced risk of experiencing LBP (OR: 0.13, 95%CI: 0.01-0.97). Nurses who reported breast tenderness prior to menstruation were twice as likely to suffer LBP (OR: 2.09, 95%CI: 1.20-3.73), while those who reported breast tenderness during menstruation were almost twice as likely to suffer LBP that interfered with their daily activities (OR: 1.85, 95%CI: 1.06-3.32). Overall, our study suggests that reproductive symptoms and menstrual disorders may influence the development of LBP among Japanese nurses, although the magnitude of this effect appears to be less than that reported in some previous research.

Risk factors of atherosclerosis and shoulder pain--is there an association? A systematic review

BACKGROUND

Shoulder pain is prevalent and a common cause of disability at work and daily activities. Some studies suggest an association between risk factors of atherosclerosis and shoulder pain and disorders.

AIM

To assess associations between risk factors of atherosclerosis and shoulder pain or disorders and to discuss possible pathophysiological pathways for found associations.

METHODS

A systematic review was conducted searching Medline until June 2006. Two authors extracted data and assessed quality independently using the Cochrane criteria for the assessment of quality in non-experimental studies with slight modifications. Due to heterogeneity of studies, meta-analysis was not possible. Results were summarized and discussed paying attention to study design and quality.

RESULTS

Fifteen papers from 14 studies were included in the review. Diabetes was consistently associated with clinically defined shoulder disorders in population studies. Overweight or obesity was associated with the incidence of shoulder symptoms in three studies and with clinically defined shoulder disorders in one case control study. A few studies showed a preventive effect of physical exercise. Associations between smoking and shoulder disorders were seen only in studies on occupational populations.

CONCLUSIONS

A consistent association between diabetes and shoulder disorders, some associations for weight-related factors as well as a possible preventive effect from physical exercise and sports suggest a metabolic pathophysiological process in shoulder disorders. More prospective studies using appropriate analytical methods are needed.

Back pain claim rates in Japan and the United States: framing the puzzle

STUDY DESIGN

This is a cross-national comparison of workers' compensation claims for back pain in Japan and the United States (US).

OBJECTIVES

The main objective is to juxtapose rates of back pain claims in Japan and Washington state. Because the Washington state rate closely matches rates for other US states as well as the rate for the US as a whole, it is used to represent the US rate. A puzzle is to be framed: Why are back pain claim rates in Japan and the United States so disparate?

SUMMARY OF BACKGROUND DATA

Occupational back pain is common among workers in both Japan and the United States. Wage compensation for time off work is also substantial in both countries and potentially induces time off work at least as much in Japan as in the United States. Accordingly, back pain claim rates in Japan seemingly would be on the same order of magnitude as rates in the United States.

METHODS

Washington state rates are based on data from its state fund. Both Japan and Washington state rates are composed of the number of workers eligible to file worker compensation claims in a given year (denominator) and the number of back pain claims accepted during that year (numerator). Because rates may fluctuate from year-to-year, 5 years of data on rates are presented, 1995-1999. Central to the comparison are Japanese and Washington state rates of workers' compensation claims for back pain with more than 3 days compensated time loss from work.

RESULTS

The back pain claim rate in 1999 was 60 times higher in Washington state than in Japan. The disparity in rates for the other years in the study (1995-1998) was similar.

CONCLUSION

Back pain is common among workers both in Japan and the United States, but there is no simple or necessary relationship between that symptom and how it manifests itself in one country or another. Rather, the symptom is protean in its social manifestations. As for what shapes those manifestations-or, more specifically, what causes the startling disparity in back pain claim rates between Japan and the United States-that is a puzzle. Various solutions to the puzzle are discussed, but it remains essentially unsolved.

Prevalence of musculoskeletal disorder among workers in Taiwan: a nationwide study

Musculoskeletal disorder (MSD) is a common problem among workers. In spite of the numerous reports on MSD in various specific groups of workers, few data on the prevalence in the general working population are available except for back pain. We analyzed the information collected through a nationwide survey in Taiwan in 1994 to estimate the prevalence of MSD by age, gender, and education level and identify high-risk industries. In the survey, a standard questionnaire was distributed to a representative sample of 22,475 non-self-employed workers in Taiwan. National estimates were obtained by applying a weight to each participant. Among the sampled workers, 18,942 (84.3%) participated, and 37.0% (standard error=0.4%) had MSD. Female workers had a significantly higher overall prevalence than male workers (39.5% vs. 35.2%, p<0.05). Education and age also had significant associations with MSD (p<0.001 in both genders). "Lower back and waist" were the most frequently affected body parts (18.3% among males and 19.7% among females), but the prevalence of MSDs of the neck, shoulders, hands and wrists were also above 10%. The top ten high-risk major industries for MSD of various body parts for each gender were identified, and some industries, including "Basic Metal Industries" and "Buildings Construction," were among the top ten for multiple body parts. Our study showed that MSDs of body parts other than the back are also prevalent, especially in the neck, shoulders, hands and wrists. We also identified high-risk industries for further research and intervention.

Musculoskeletal disorders in relation to age and occupation in Swedish construction workers

BACKGROUND

Physical exposure load varies between trades in the construction industry. Our hypothesis is that the prevalence of MSD in a trade, reflects the level of physical exposure; the aim of the study was to describe MSD in relation to age and occupation within the industry.

METHODS

The study is based on data from self-administered questionnaires filled out by 85,191 males in the Swedish construction industry.

RESULTS

Construction workers had higher age-adjusted prevalence of MSD than foremen and office workers. In general prevalence rates increased steadily with age. Scaffolders showed the highest prevalence of MSD in all body locations. Elevated prevalence of neck disorders was found in crane operators, insulators, and painters, and of lower back and lower extremity disorders in roofers and floorers.

CONCLUSION

MSD increase with age. The variation between trades of MSD prevalence seems to correspond to the variation with respect to physical exposure.